Healthcare Provider Details

I. General information

NPI: 1124944616
Provider Name (Legal Business Name): KRISTINE ANITA COLE LDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3921 SW COLLEGE RD
OCALA FL
34474-5713
US

IV. Provider business mailing address

6412 N TAMARIND AVE
HERNANDO FL
34442-2279
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-1000
  • Fax: 352-873-9414
Mailing address:
  • Phone: 407-415-2075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number4243
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: